Content area
Full Text
Introduction
Community-acquired pneumonia (CAP) is a cause of considerable morbidity and mortality in adults in developed countries, leading to high rates of hospitalisations, especially in the elderly. 1 2 The 2010 Global Burden of Disease Study reported that lower respiratory tract infections, including pneumonia, are the fourth most common cause of death globally, exceeded only by ischaemic heart disease, strokes and chronic obstructive pulmonary disease (COPD), and they are the second most frequent reason for years of life lost. 3 Within Europe, CAP is the leading cause of death due to infection, 2 with approximately 90% of deaths due to pneumonia occurring in people aged >65 years. 4 Pneumonia places a considerable burden on healthcare resources and society, with associated annual costs in Europe estimated at approximately [euro]10 billion, mainly due to hospitalisation and lost working days. 5
Several risk factors for CAP are recognised, including age >65 years, 1 6 7 smoking, 6 alcoholism, 7 immunosuppressive conditions, 7 and conditions such as COPD, 8 cardiovascular disease, cerebrovascular disease, chronic liver or renal disease, diabetes mellitus and dementia. 9 Although many European studies have reported on the incidence of CAP and associated risk factors, no comprehensive overviews of these data are currently available. This literature review was conducted to generate up-to-date information on the incidence of CAP in adults in Europe, and of the risk factors for contracting CAP. A secondary objective was to collect data on the rates of comorbidities in patients with CAP.
Methods
The PubMed database was searched using the following search string: pneumonia AND English AND 2005/01/01-2012/07/31 AND risk NOT clinical trial, phase i OR clinical trial, phase ii OR clinical trial, phase iii OR controlled clinical trial OR randomised controlled trial OR case reports OR practice guideline OR editorial OR review OR cost OR cost effectiveness OR efficacy OR immunogenicity OR economic OR nosocomial. Additional searches used the same search string, but replaced 'risk' with either 'comorbidity' or 'co-morbidity'.
Papers were included if they reported observational studies performed in Western European countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, The Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, UK) and presented data from individuals aged >15 years on any of the following: incidence of CAP in at-risk individuals, defined as...